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Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

In the early days of mobile health apps and wearable medical devices, providers weren’t sure they could cope with yet another data stream. But as the uptake of these apps and devices has grown over the last two years, at a rate surpassing virtually everyone’s expectations, providers and payers both have had to plan for a day when wearable and smartphone app data become part of the standard dataflow. The potentially billion-dollar question is whether they can figure out when, where and how they need to secure such data.

To do that, providers are going to have to face up to new security risks that they haven’t faced before, as well as doing a good job of educating patients on when such data is HIPAA-protected and when it isn’t. While I am most assuredly not an attorney, wiser legal heads than mine have reported that once wearable/app data is used by providers, it’s protected by HIPAA safeguards, but in other situations — such as when it’s gathered by employers or payers — it may not be protected.

For an example of the gray areas that bedevil mobile health data security, consider the case of upstart health insurance provider Oscar Health, which recently offered free Misfit Flash bands to its members. The company’s leaders have promised members that use the bands that if their collected activity numbers look good, they’ll offer roughly $240 off their annual premium. And they’ve promised that the data will be used for diagnostics or any other medical purpose. This promise may be worthless, however, if they are still legally free to resell this data to say, pharmaceutical companies.

Logical and physical security

Meanwhile, even if providers, payers and employers are very cautious about violating patients’ privacy, their careful policies will be worth little if they don’t take a look at managing the logical and physical security risks inherent in passing around so much data across multiple Wi-Fi, 4G and corporate networks.

While it’s not yet clear what the real vulnerabilities are in shipping such data from place to place, it’s clear that new security holes will pop up as smartphone and wearable health devices ramp up to sharing data on massive scale. In an industry which is still struggling with BYOD security, corralling data that facilities already work with on a daily basis, it’s going to pose an even bigger challenge to protect and appropriately segregate connected health data.

After all, every time you begin to rely on a new network model which involves new data handoff patterns — in this case from wired medical device or wearable data streaming to smartphones across Wi-Fi networks, smart phones forwarding data to providers via 4G LTE cellular protocols and providers processing the data via corporate networks, there has to be a host of security issues we haven’t found yet.

Cybersecurity problems could lead to mHealth setbacks

Worst of all, hospitals’ and medical practices’ cyber security protocols are quite weak (as researcher after researcher has pointed out of late). Particularly given how valuable medical identity data has become, healthcare organizations need to work harder to protect their cyber assets and see to it that they’ve at least caught the obvious holes.

But to date, if our experiences with medical device security are any indication, not only are hospitals and practices vulnerable to standard cyber hacks on network assets, they’re also finding it difficult to protect the core medical devices needed to diagnose and treat patients, such as MRI machines, infusion pumps and even, in theory, personal gear like pacemakers and insulin pumps. It doesn’t inspire much confidence that the Conficker worm, which attacked medical devices across the world several years ago, is still alive and kicking, and in fact, accounted for 31% the year’s top security threats.

If malevolent outsiders mount attacks on the flow of connected health data, and succeed at stealing it, not only is it a brand-new headache for healthcare IT administrators, it could create a crisis of confidence among mHealth shareholders. In other words, while patients, providers, payers, employers and even pharmaceutical companies seem comfortable with the idea of tapping digital health data, major hacks into that data could slow the progress of such solutions considerably. Let’s hope those who focus on health IT security take the threat to wearables and smartphone health app data seriously going into 2015.

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